Healthcare Provider Details

I. General information

NPI: 1922212356
Provider Name (Legal Business Name): HANSANG NOH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 12/03/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24902 MOULTON PKWY
LAGUNA HILLS CA
92637-6403
US

IV. Provider business mailing address

PO BOX 2549
MISSION VIEJO CA
92690-0549
US

V. Phone/Fax

Practice location:
  • Phone: 949-462-0560
  • Fax: 949-462-3910
Mailing address:
  • Phone: 949-462-0560
  • Fax: 949-462-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA98834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: